1
|
Lai YK, Ye JF, Ao SH, Zhao X. Overcoming obstacles to mammography screening: Examining the role of offline healthcare barriers and online patient-provider communication. J Health Psychol 2024; 29:452-466. [PMID: 38411143 DOI: 10.1177/13591053241234260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024] Open
Abstract
Barriers to accessing offline healthcare may discourage patients from undergoing mammography screening. Online patient-provider communication (OPPC) offers a supplementary health resource that can complement traditional medical encounters and facilitate mammography screening. This study examines how offline healthcare barriers influence mammography screening, taking into account OPPC as an independent variable and cancer fatalism and patient activation as two mediators. Data from the 2017, 2018, and 2020 iterations of the Health Information National Trends Survey were used for this study. Results showed that OPPC was positively linked to mammography screening. Offline healthcare barriers had a negative association with patient activation and subsequent mammography behaviors. Moreover, offline healthcare barriers and OPPC were associated with mammography screening through serial mediation of cancer fatalism and patient activation. This study has important implications for encouraging mammography screening.
Collapse
|
2
|
Zigler CK, Adeyemi O, Boyd AD, Braciszewski JM, Cheville A, Cuthel AM, Dailey DL, Del Fiol G, Ezenwa MO, Faurot KR, Justice M, Ho PM, Lawrence K, Marsolo K, Patil CL, Paek H, Richesson RL, Staman KL, Schlaeger JM, O'Brien EC. Collecting patient-reported outcome measures in the electronic health record: Lessons from the NIH pragmatic trials Collaboratory. Contemp Clin Trials 2024; 137:107426. [PMID: 38160749 PMCID: PMC10922303 DOI: 10.1016/j.cct.2023.107426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/15/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The NIH Pragmatic Trials Collaboratory supports the design and conduct of 27 embedded pragmatic clinical trials, and many of the studies collect patient reported outcome measures as primary or secondary outcomes. Study teams have encountered challenges in the collection of these measures, including challenges related to competing health care system priorities, clinician's buy-in for adoption of patient-reported outcome measures, low adoption and reach of technology in low resource settings, and lack of consensus and standardization of patient-reported outcome measure selection and administration in the electronic health record. In this article, we share case examples and lessons learned, and suggest that, when using patient-reported outcome measures for embedded pragmatic clinical trials, investigators must make important decisions about whether to use data collected from the participating health system's electronic health record, integrate externally collected patient-reported outcome data into the electronic health record, or collect these data in separate systems for their studies.
Collapse
Affiliation(s)
- Christina K Zigler
- Duke University School of Medicine, Durham, NC, United States of America.
| | - Oluwaseun Adeyemi
- New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, NY, United States of America
| | - Andrew D Boyd
- Department of Biomedical and Health Information Sciences, University of Illinois Chicago, Chicago, IL, United States of America
| | | | - Andrea Cheville
- Mayo Clinic Comprehensive Cancer Center, Rochester, MN, United States of America
| | - Allison M Cuthel
- New York University Grossman School of Medicine, Ronald O. Perelman Department of Emergency Medicine, New York, NY, United States of America
| | - Dana L Dailey
- St. Ambrose University, Davenport, IA, and University of Iowa, Iowa City, IA, United States of America
| | - Guilherme Del Fiol
- Department of Biomedical Informatics, University of Utah School of Medicine, Salt Lake City, UT, United States of America
| | - Miriam O Ezenwa
- University of Florida College of Nursing, Gainesville, FL, United States of America
| | - Keturah R Faurot
- Department of Physical Medicine and Rehabilitation, University of North Carolina School of Medicine, Chapel Hill, NC, United States of America
| | - Morgan Justice
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States of America
| | - P Michael Ho
- Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, United States of America
| | - Katherine Lawrence
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Keith Marsolo
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States of America
| | - Crystal L Patil
- University of Michigan, School of Nursing, Ann Arbor, MI, United States of America
| | - Hyung Paek
- Yale University, New Haven, CT, United States of America
| | - Rachel L Richesson
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, United States of America
| | - Karen L Staman
- Duke Clinical Research Institute, Durham, NC, United States of America
| | - Judith M Schlaeger
- University of Illinois Chicago, College of Nursing, Chicago, IL, United States of America
| | - Emily C O'Brien
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, United States of America
| |
Collapse
|
3
|
Fritz JM, Gibson B, Wetter DW, Del Fiol G, Solis V, Ford I, Lundberg K, Thackeray A. Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study. Implement Sci Commun 2024; 5:3. [PMID: 38183154 PMCID: PMC10768478 DOI: 10.1186/s43058-023-00542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/21/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Considerable disparities in chronic pain management have been identified. Persons in rural, lower income, and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with chronic pain is a promising strategy to lessen disparities, but implementation comes with many challenges. The BeatPain Utah study is a hybrid type 1 effectiveness-implementation pragmatic clinical trial investigating telehealth strategies to provide nonpharmacologic care from physical therapists to persons with chronic back pain receiving care in ommunity health centers (CHCs). CHCs provide primary care to all persons regardless of ability to pay. This paper outlines the use of implementation mapping to develop a multifaceted implementation plan for the BeatPain study. METHODS During a planning year for the BeatPain trial, we developed a comprehensive logic model including the five-step implementation mapping process informed by additional frameworks and theories. The five iterative implementation mapping steps were addressed in the planning year: (1) conduct needs assessments for involved groups; (2) identify implementation outcomes, performance objectives, and determinants; (3) select implementation strategies; (4) produce implementation protocols and materials; and (5) evaluate implementation outcomes. RESULTS CHC leadership/providers, patients, and physical therapists were identified as involved groups. Barriers and assets were identified across groups which informed identification of performance objectives necessary to implement two key processes: (1) electronic referral of patients with back pain in CHC clinics to the BeatPain team and (2) connecting patients with physical therapists providing telehealth. Determinants of the performance objectives for each group informed our choice of implementation strategies which focused on training, education, clinician support, and tailoring physical therapy interventions for telehealth delivery and cultural competency. We selected implementation outcomes for the BeatPain trial to evaluate the success of our implementation strategies. CONCLUSIONS Implementation mapping provided a comprehensive and systematic approach to develop an implementation plan during the planning phase for our ongoing hybrid effectiveness-implementation trial. We will be able to evaluate the implementation strategies used in the BeatPain Utah study to inform future efforts to implement telehealth delivery of evidence-based pain care in CHCs and other settings. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04923334 . Registered June 11, 2021.
Collapse
Affiliation(s)
- Julie M Fritz
- Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Dr., Room 391, Salt Lake City, UT, 84108, USA.
| | - Bryan Gibson
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - David W Wetter
- Department of Population Health Sciences, Center for Health Outcomes and Population Equity, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Guilherme Del Fiol
- Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA
| | - Victor Solis
- Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Dr., Room 391, Salt Lake City, UT, 84108, USA
| | - Isaac Ford
- Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Dr., Room 391, Salt Lake City, UT, 84108, USA
| | - Kelly Lundberg
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Anne Thackeray
- Department of Physical Therapy & Athletic Training, University of Utah, 383 Colorow Dr., Room 391, Salt Lake City, UT, 84108, USA
| |
Collapse
|
4
|
Choi SL, Hites L, Bolland AC, Lee J, Payne-Foster P, Bissell K. Telehealth uptake among middle-aged and older Americans during COVID-19: chronic conditions, social media communication, and race/ethnicity. Aging Ment Health 2024; 28:160-168. [PMID: 36450359 DOI: 10.1080/13607863.2022.2149696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/14/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVES This study investigated whether and to what extent constructs of the protection motivation theory of health (PMT)-threat appraisal (perceived vulnerability/severity) and coping appraisal (response efficacy and self-efficacy)-are related to telehealth engagement during the COVID-19 pandemic, and how these associations differ by race/ethnicity among middle-aged and older Americans. METHODS Data were from the 2020 Health and Retirement Study. Multivariable ordinary least-squares regression analyses were computed adjusting for health and sociodemographic factors. RESULTS Some PMT constructs are useful in understanding telehealth uptake. Perceived vulnerability/severity, particularly comorbidity (b = 0.13, 95% confidence interval (CI) [0.11, 0.15], p < 0.001), and response efficacy, particularly participation in communication via social media (b = 0.24, 95% CI [0.21, 0.27], p < 0.001), were significantly and positively associated with higher telehealth uptake during the COVID-19 pandemic among middle-aged and older Americans. Non-Hispanic Black adults were more likely to engage in telehealth during the pandemic than their non-Hispanic White counterparts (b = 0.20, 95% CI [0.12, 0.28], p < 0.001). Multiple moderation analyses revealed the significant association between comorbidity and telehealth uptake was similar across racial/ethnic groups, whereas the significant association between social media communication and telehealth uptake varied by race/ethnicity. Specifically, the association was significantly less pronounced for Hispanic adults (b = -0.11, 95% CI [-0.19, -0.04], p < 0.01) and non-Hispanic Asian/other races adults (b = -0.13, 95% CI [-0.26, -0.01], p < 0.05) than it was for their non-Hispanic White counterparts. CONCLUSION Results suggest the potential of using social media and telehealth to narrow health disparities, particularly serving as a bridge for members of underserved communities to telehealth uptake.
Collapse
Affiliation(s)
- Shinae L Choi
- Department of Consumer Sciences, College of Human Environmental Sciences, The University of Alabama, Tuscaloosa, AL, USA
- Center for Innovation in Social Science, College of Arts and Sciences, Boston University, Boston, MA, USA
| | - Lisle Hites
- Department of Community Medicine and Population Health, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Anneliese C Bolland
- Department of Communication Studies, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Jiyoung Lee
- Department of Journalism and Creative Media, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Pamela Payne-Foster
- Department of Community Medicine and Population Health, College of Community Health Sciences, The University of Alabama, Tuscaloosa, AL, USA
| | - Kimberly Bissell
- Department of Journalism and Creative Media, College of Communication and Information Sciences, The University of Alabama, Tuscaloosa, AL, USA
| |
Collapse
|
5
|
Fritz JM, Gibson B, Wetter DW, Fiol GD, Solis VH, Ford I, Lundberg K, Thackeray A. Use of implementation mapping in the planning of a hybrid type 1 pragmatic clinical trial: the BeatPain Utah study. RESEARCH SQUARE 2023:rs.3.rs-3267087. [PMID: 37790359 PMCID: PMC10543377 DOI: 10.21203/rs.3.rs-3267087/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Background Considerable disparities in chronic pain management have been identified. Persons in rural, lower income and minoritized communities are less likely to receive evidence-based, nonpharmacologic care. Telehealth delivery of nonpharmacologic, evidence-based interventions for persons with chronic pain is a promising strategy to lessen disparities, but implementation comes with many challenges. The BeatPain Utah study is a hybrid type I effectiveness-implementation pragmatic clinical trial investigating telehealth strategies to provide nonpharmacologic care from physical therapists to persons with chronic back pain receiving care in Community Health Centers (CHCs). CHCs provide primary care to all persons regardless of ability to pay. This paper outlines the use of implementation mapping to develop a multifaceted implementation plan for the BeatPain study. Methods During a planning year for the BeatPain trial we developed a comprehensive logic model including the 5-step implementation mapping process informed by additional frameworks and theories. The five iterative implementation mapping steps were addressed in the planning year; 1) conduct needs assessments for involved groups; 2) identify implementation outcomes, performance objectives and determinants; 3) select implementation strategies; 4) produce implementation protocols and materials; and 5) evaluate implementation outcomes. Results CHC leadership/providers, patients and physical therapists were identified as involved groups. Barriers and assets were identified across groups which informed identification of performance objectives necessary to implement two key processes; 1) electronic referral of patients with back pain in CHC clinics to the BeatPain team; and 2) connecting patients with physical therapists providing telehealth. Determinants of the performance objectives for each group informed our choice of implementation strategies which focused on training, education, clinician support and tailoring physical therapy interventions for telehealth delivery and cultural competency. We selected implementation outcomes for the BeatPain trial to evaluate the success of our implementation strategies. Conclusions Implementation mapping provided a comprehensive and systematic approach to develop an implementation plan during the planning phase for our ongoing hybrid effectiveness-implementation trial. We will be able to evaluate the implementation strategies used in the BeatPain Utah study to inform future efforts to implement telehealth delivery of evidence-based pain care in CHCs and other settings. Trial registration Clinicaltrials.gov Identifier: NCT04923334. Registered June 11, 2021 (https://clinicaltrials.gov/study/NCT04923334.
Collapse
|
6
|
Kim J, Linos E, Fishman DA, Dove MS, Hoch JS, Keegan TH. Factors Associated with Online Patient-Provider Communications Among Cancer Survivors in the United States during COVID: A Cross-Sectional Study. JMIR Cancer 2023; 9:e44339. [PMID: 37074951 DOI: 10.2196/44339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/05/2023] [Accepted: 04/17/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Online Patient-Provider Communication (OPPC) is crucial in enhancing access to health information, self-care, and related health outcomes among cancer survivors. The necessity of OPPC increased during SARS/COVID-19 (COVID), yet investigations in vulnerable subgroups have been limited. OBJECTIVE Thus, this study aimed to assess the prevalence of OPPC and sociodemographic and clinical characteristics associated with OPPC among cancer survivors and adults without a history of cancer during COVID vs. pre-COVID. METHODS Nationally representative cross-sectional survey data (Health Information National Trends Survey, HINTS 5 2017-2020) was used among cancer survivors (n= 1,900) and adults without a history of cancer (n= 13, 292). COVID included data from February to June 2020. We calculated the prevalence of three types of OPPC, defined as using email/internet, tablet/smartphone, or Electronic Health Records (EHR) for patient-provider communication, in the past 12 months. To investigate the associations of sociodemographic and clinical factors with OPPC, multivariable-adjusted weighted logistic regression was performed to obtain odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS The average prevalence of OPPC increased from pre-COVID to COVID among cancer survivors (39.7% vs. 49.7%, email/internet; 32.2% vs. 37.9%, tablet/smartphone; 19.0% vs. 30.0%, EHR). Cancer survivors (OR=1.32, 95% CI 1.06-1.63) were slightly more likely to use email/internet communications than adults without a history of cancer prior to COVID. Among cancer survivors, email/internet (OR=1.61, 1.08-2.40) and EHR (OR=1.92, 1.22-3.02) were more likely to be used during COVID than pre-COVID. During COVID, subgroups of cancer survivors, including Hispanics (OR=0.26, 0.09-0.71 vs. non-Hispanic Whites), or those with the lowest income (OR=6.14, 1.99-18.92 $50,000 to <$75,000; OR=0.42, 1.56-11.28 ≥ $75,000 vs. <$20,000), with no usual source of care (OR=6.17, 2.12-17.99), or reporting depression (OR=0.33, 0.14-0.78) were less likely to use email/internet and those who were the oldest (OR=9.33, 2.18-40.01 age 35-49; OR=3.58, 1.20-10.70 age 50-64; OR=3.09, 1.09-8.76 age 65-74 vs. ≥75), unmarried (OR=2.26, 1.06-4.86) or had public/no health insurance (ORs=0.19-0.21 Medicare, Medicaid, or Other, vs. private) were less likely to use tablet/smartphone to communicate with providers. Cancer survivors with a usual source of care (OR=6.23, 1.66-23.39) or healthcare office visits within a year (ORs=7.55-8.25) were significantly more likely to use EHR to communicate. While not observed in cancer survivors, lower education level was associated with lower OPPC among adults without a history of cancer during COVID. CONCLUSIONS Our findings identified vulnerable subgroups of cancer survivors who were left behind in online patient-provider communications which are becoming an increasing part of healthcare. Those vulnerable subgroups of cancer survivors with lower OPPC should be helped through multidimensional interventions to prevent further inequities. CLINICALTRIAL Not applicable.
Collapse
Affiliation(s)
- Jiyeong Kim
- Department of Public Health Sciences, School of Medicine, University of California, Davis, 1 Shields Ave, Davis, US
| | - Eleni Linos
- Department of Epidemiology and Population Health, School of Medicine, Stanford University, Stanford, US
- Department of Dermatology, School of Medicine, Stanford University, Stanford, US
| | - Debra A Fishman
- Health Management and Education, UC Davis Health Cardiac Rehabilitation, Davis, US
| | - Melanie S Dove
- Division of Health Policy and Management, Department of Public Health Sciences, University of California, Davis, Davis, US
| | - Jeffrey S Hoch
- Division of Health Policy and Management, Department of Public Health Sciences, Center for Healthcare Policy and Research, University of California, Davis, Davis, US
| | - Theresa H Keegan
- Division of Hematology and Oncology, UC Davis Comprehensive Cancer Center, Sacramento, US
| |
Collapse
|
7
|
Kee D, Jetté N, Blank LJ, Kummer BR, Mazumdar M, Agarwal P. Latent class analysis of eHealth behaviors among adults with epilepsy. Epilepsia 2023; 64:479-499. [PMID: 36484565 DOI: 10.1111/epi.17483] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 11/10/2022] [Accepted: 12/08/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The objective of this study was to determine the proportions of uptake and factors associated with electronic health (eHealth) behaviors among adults with epilepsy. METHODS The 2013, 2015, and 2017 National Health Interview Surveys were analyzed. We assessed the proportions of use of five domains of eHealth in those with epilepsy: looked up health information on the internet, filled a prescription on the internet, scheduled a medical appointment on the internet, communicated with a health care provider via email, and used chat groups to learn about health topics. Multivariate logistic regressions were conducted to identify factors associated with any eHealth behaviors among those with active epilepsy. Latent class analysis was performed to identify underlying patterns of eHealth activity. Survey participants were classified into three discrete classes: (1) frequent, (2) infrequent, and (3) nonusers of eHealth. Multinomial logistic regression was performed to identify factors associated with frequency of eHealth use. RESULTS There were 1770 adults with epilepsy, of whom 65.87% had at least one eHealth behavior in the prior year. By domain, 62.61% looked up health information on the internet, 15.81% filled a prescription on the internet, 14.95% scheduled a medical appointment on the internet, 17.20% communicated with a health care provider via email, and 8.27% used chat groups to learn about health topics. Among those with active epilepsy, female sex, more frequent computer usage, and internet usage were associated with any eHealth behavior. Female sex and frequent computer use were associated with frequent eHealth use as compared to nonusers. SIGNIFICANCE A majority of persons with epilepsy were found to use at least one form of eHealth. Various technological and demographic factors were associated with eHealth behaviors. Individuals with lower eHealth behaviors should be provided with targeted interventions that address barriers to the adoption of these technologies.
Collapse
Affiliation(s)
- Dustin Kee
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Nathalie Jetté
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Leah J Blank
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Benjamin R Kummer
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Clinical Informatics, Mount Sinai Health System, New York, New York, USA
| | - Madhu Mazumdar
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Parul Agarwal
- Institute for Healthcare Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
8
|
Inequity in Access and Delivery of Virtual Care Interventions: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159411. [PMID: 35954768 PMCID: PMC9367842 DOI: 10.3390/ijerph19159411] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 07/25/2022] [Accepted: 07/27/2022] [Indexed: 01/27/2023]
Abstract
The objectives of this review were to map and summarize the existing evidence from a global perspective about inequity in access and delivery of virtual care interventions and to identify strategies that may be adopted by virtual care services to address these inequities. We searched MEDLINE, EMBASE, and CINAHL using both medical subject headings (MeSH) and free-text keywords for empirical studies exploring inequity in ambulatory services offered virtually. Forty-one studies were included, most of them cross-sectional in design. Included studies were extracted using a customized extraction tool, and descriptive analysis was performed. The review identified widespread differences in accessing and using virtual care interventions among cultural and ethnic minorities, older people, socioeconomically disadvantaged groups, people with limited digital and/or health literacy, and those with limited access to digital devices and good connectivity. Potential solutions addressing these barriers identified in the review included having digitally literate caregivers present during virtual care appointments, conducting virtual care appointments in culturally sensitive manner, and having a focus on enhancing patients’ digital literacy. We identified evidence-based practices for virtual care interventions to ensure equity in access and delivery for their virtual care patients.
Collapse
|
9
|
Fridman I, Smalls A, Fleming P, Elston Lafata J. Preferences for electronic modes of communication among older primary care patients: a cross-sectional survey (Preprint). JMIR Form Res 2022; 7:e40709. [DOI: 10.2196/40709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 03/15/2023] [Accepted: 04/03/2023] [Indexed: 04/05/2023] Open
|
10
|
Jacob C, Sezgin E, Sanchez-Vazquez A, Ivory C. Sociotechnical Factors Affecting Patients' Adoption of Mobile Health Tools: Systematic Literature Review and Narrative Synthesis. JMIR Mhealth Uhealth 2022; 10:e36284. [PMID: 35318189 PMCID: PMC9121221 DOI: 10.2196/36284] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 12/23/2022] Open
Abstract
Background Mobile health (mHealth) tools have emerged as a promising health care technology that may contribute to cost savings, better access to care, and enhanced clinical outcomes; however, it is important to ensure their acceptance and adoption to harness this potential. Patient adoption has been recognized as a key challenge that requires further exploration. Objective The aim of this review was to systematically investigate the literature to understand the factors affecting patients’ adoption of mHealth tools by considering sociotechnical factors (from technical, social, and health perspectives). Methods A structured search was completed following the participants, intervention, comparators, and outcomes framework. We searched the MEDLINE, PubMed, Cochrane Library, and SAGE databases for studies published between January 2011 and July 2021 in the English language, yielding 5873 results, of which 147 studies met the inclusion criteria. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and the Cochrane Handbook were followed to ensure a systematic process. Extracted data were analyzed using NVivo (QSR International), with thematic analysis and narrative synthesis of emergent themes. Results The technical factors affecting patients’ adoption of mHealth tools were categorized into six key themes, which in turn were divided into 20 subthemes: usefulness, ease of use, data-related, monetary factors, technical issues, and user experience. Health-related factors were categorized into six key themes: the disease or health condition, the care team’s role, health consciousness and literacy, health behavior, relation to other therapies, integration into patient journey, and the patients’ insurance status. Social and personal factors were divided into three key clusters: demographic factors, personal characteristics, and social and cultural aspects; these were divided into 19 subthemes, highlighting the importance of considering these factors when addressing potential barriers to mHealth adoption and how to overcome them. Conclusions This review builds on the growing body of research that investigates patients’ adoption of mHealth services and highlights the complexity of the factors affecting adoption, including personal, social, technical, organizational, and health care aspects. We recommend a more patient-centered approach by ensuring the tools’ fit into the overall patient journey and treatment plan, emphasizing inclusive design, and warranting comprehensive patient education and support. Moreover, empowering and mobilizing clinicians and care teams, addressing ethical data management issues, and focusing on health care policies may facilitate adoption.
Collapse
Affiliation(s)
- Christine Jacob
- University of Applied Sciences Northwestern Switzerland, Olten, Switzerland
| | - Emre Sezgin
- The Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, United States.,NORC at the University of Chicago, Chicago, IL, United States
| | - Antonio Sanchez-Vazquez
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Chris Ivory
- Innovative Management Practice Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| |
Collapse
|
11
|
Naeem I, Quan H, Singh S, Chowdhury N, Chowdhury M, Saini V, Tc T. Factors Associated With Willingness to Share Health Information: Rapid Review. JMIR Hum Factors 2022; 9:e20702. [PMID: 35138263 PMCID: PMC8867291 DOI: 10.2196/20702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/30/2020] [Accepted: 10/11/2021] [Indexed: 11/25/2022] Open
Abstract
Background To expand research and strategies to prevent disease, comprehensive and real-time data are essential. Health data are increasingly available from platforms such as pharmaceuticals, genomics, health care imaging, medical procedures, wearable devices, and internet activity. Further, health data are integrated with an individual’s sociodemographic information, medical conditions, genetics, treatments, and health care. Ultimately, health information generation and flow are controlled by the patient or participant; however, there is a lack of understanding about the factors that influence willingness to share health information. A synthesis of the current literature on the multifactorial nature of health information sharing preferences is required to understand health information exchange. Objective The objectives of this review are to identify peer-reviewed literature that reported factors associated with health information sharing and to organize factors into cohesive themes and present a narrative synthesis of factors related to willingness to share health information. Methods This review uses a rapid review methodology to gather literature regarding willingness to share health information within the context of eHealth, which includes electronic health records, personal health records, mobile health information, general health information, or information on social determinants of health. MEDLINE and Google Scholar were searched using keywords such as electronic health records AND data sharing OR sharing preference OR willingness to share. The search was limited to any population that excluded health care workers or practitioners, and the participants aged ≥18 years within the US or Canadian context. The data abstraction process using thematic analysis where any factors associated with sharing health information were highlighted and coded inductively within each article. On the basis of shared meaning, the coded factors were collated into major themes. Results A total of 26 research articles met our inclusion criteria and were included in the qualitative analysis. The inductive thematic coding process revealed multiple major themes related to sharing health information. Conclusions This review emphasized the importance of data generators’ viewpoints and the complex systems of factors that shape their decision to share health information. The themes explored in this study emphasize the importance of trust at multiple levels to develop effective information exchange partnerships. In the case of improving precision health care, addressing the factors presented here that influence willingness to share information can improve sharing capacity for individuals and allow researchers to reorient their methods to address hesitation in sharing health information.
Collapse
Affiliation(s)
- Iffat Naeem
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada
| | - Hude Quan
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Shaminder Singh
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB, Canada
| | - Nashit Chowdhury
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mohammad Chowdhury
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Vineet Saini
- O'Brien Institute of Public Health, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Research and Innovation - Provincial Population and Public Health, Alberta Health Services, Calgary, AB, Canada
| | - Turin Tc
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| |
Collapse
|
12
|
Yang R, Zeng K, Jiang Y. Prevalence, Factors, and Association of Electronic Communication Use With Patient-Perceived Quality of Care From the 2019 Health Information National Trends Survey 5-Cycle 3: Exploratory Study. J Med Internet Res 2022; 24:e27167. [PMID: 35119369 PMCID: PMC8857700 DOI: 10.2196/27167] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 06/25/2021] [Accepted: 11/10/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Electronic communication (e-communication), referring to communication through electronic platforms such as the web, patient portal, or mobile phone, has become increasingly important, as it extends traditional in-person communication with fewer limitations of timing and locations. However, little is known about the current status of patients' use of e-communication with clinicians and whether the use is related to the better patient-perceived quality of care at the population level. OBJECTIVE The aim of this study was to explore the prevalence of and the factors associated with e-communication use and the association of e-communication use with patient-perceived quality of care by using the nationally representative sample of the 2019 Health Information National Trends Survey 5 (HINTS 5)-Cycle 3. METHODS Data from 5438 adult responders (mean age 49.04 years, range 18-98 years) were included in this analysis. Multiple logistic and linear regressions were conducted to explore responders' personal characteristics related to their use of e-communication with clinicians in the past 12 months and how their use was related to perceived quality of care. Descriptive analyses for e-communication use according to age groups were also performed. All analyses considered the complex survey design using the jackknife replication method. RESULTS The overall prevalence of e-communication use was 60.3%, with a significantly lower prevalence in older adults (16.6%) than that in <45-year-old adults (41%) and 45-65-year-old adults (42.4%). All percentages are weighted; therefore, absolute values are not shown. American adults who used e-communication were more likely to be high school graduates (odds ratio [OR] 1.95, 95% CI 1.14-3.34; P=.02), some college degree holders (OR 3.34, 95% CI 1.84-6.05; P<.001), and college graduates or more (OR 4.89, 95% CI 2.67-8.95; P<.001). Further, people who were females (OR 1.47, 95% CI 1.18-1.82; P=.001), with a household income ≥US $50,000 (OR 1.63, 95% CI 1.23-2.16; P=.001), with more comorbidities (OR 1.22, 95% CI 1.07-1.40; P=.004), or having a regular health care provider (OR 2.62, 95% CI 1.98-3.47; P<.001), were more likely to use e-communication. In contrast, those who resided in rural areas (OR 0.61, 95% CI 0.43-0.88; P=.009) were less likely to use e-communication. After controlling for the sociodemographics, the number of comorbidities, and relationship factors (ie, having a regular provider and trusting a doctor), e-communication use was found to be significantly associated with better perceived quality of care (β=.12, 95% CI 0.02-0.22; P=.02). CONCLUSIONS This study confirmed the positive association between e-communication use and patient-perceived quality of care and suggested that policy-level attention should be raised to engage the socially disadvantaged (ie, those with lower levels of education and income, without a regular health care provider, and living in rural areas) to maximize e-communication use and to support better patient-perceived quality of care among American adults.
Collapse
Affiliation(s)
- Rumei Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Kai Zeng
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Yun Jiang
- School of Nursing, University of Michigan, Ann Arbor, MI, United States
| |
Collapse
|
13
|
Chandrasekaran R, Katthula V, Moustakas E. Too old for technology? Use of wearable healthcare devices by older adults and their willingness to share health data with providers. Health Informatics J 2021; 27:14604582211058073. [PMID: 34802315 DOI: 10.1177/14604582211058073] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Wearable healthcare devices offer tremendous promise to effectively track and improve the well-being of older adults. Yet, little is known about the use of wearable devices by older adults. Drawing upon a national survey in US with 1481 older adults, we examine the use of wearable healthcare devices and the key predictors of use viz. sociodemographic factors, health conditions, and technology self-efficacy. We also examine if the predictors are associated with elders' willingness to share health data from wearable devices with healthcare providers. We find low level of wearable use (17.49%) among US older adults. We find significant positive associations between technology self-efficacy, health conditions, and demographic factors (gender, race, education, and annual household income) and use of wearable devices. Men were less likely (OR = 0.62, 95% CI 0.36-1.04) and Asians were more likely (OR = 2.60, 95% CI 0.89-7.64) to use wearables, as did healthy adults (OR = 1.98, 95% CI 1.37-2.87). Those who electronically communicated with their doctors (OR = 1.86, 95% CI 1.16-2.97), and those who searched online for health information (OR = 1.79, 95% CI 1.03-3.10) were more likely to use wearables. Though 80.15% of wearable users are willing to share health data with providers, those with greater technology self-efficacy and favorable attitudes toward exercise are more willing.
Collapse
Affiliation(s)
| | - Vipanchi Katthula
- Center for Health Information Management & Systems, University of Illinois at Chicago, Chicago, IL, USA
| | - Evangelos Moustakas
- Centre of Innovation and Excellence, 156575Middlesex University, Dubai, United Arab Emirates
| |
Collapse
|
14
|
Langford AT, Orellana K, Buderer N. Use of Online Medical Records to Support Medical Decision Making: A Cross-Sectional Study of US Adults. JOURNAL OF HEALTH COMMUNICATION 2021; 26:618-625. [PMID: 34637375 DOI: 10.1080/10810730.2021.1983893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The use of online medical records has increased over time and may enhance patient involvement in medical decisions. We explored sociodemographic, medical condition, and digital health correlates of using online medical records to support medical decision making. Cross-sectional data from the 2019 Health Information National Trends Survey (HINTS 5, Cycle 3, N = 5438) were analyzed. Final analyses included participants who accessed their online medical records within 12 months and had complete data for all variables (n = 1807). The outcome was, "In the past 12 months have you used your online medical record to help you make a decision about how to treat an illness or condition (yes/no)?" Univariate and multivariate odds ratios and 95% confidence intervals were calculated. Multivariately, the odds of using online medical records to support medical decision making were significantly higher for individuals who (a) used online medical records to securely send messages to health care providers, (b) used a smartphone health app to access their online medical records, (c) had online medical records that contained clinical notes, (d) reported that online medical records were useful for monitoring health, and (e) self-identified as African American, Asian, or "Other." Online medical records may support medical decision making depending on the context.
Collapse
Affiliation(s)
| | - Kerli Orellana
- Population Health, NYU Langone Health, New York, New York, USA
| | - Nancy Buderer
- Nancy Buderer Consulting, LLC, Oak Harbor, Ohio, USA
| |
Collapse
|
15
|
Pattern of Use of Electronic Health Record (EHR) among the Chronically Ill: A Health Information National Trend Survey (HINTS) Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147254. [PMID: 34299705 PMCID: PMC8304473 DOI: 10.3390/ijerph18147254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 12/20/2022]
Abstract
Effective patient–provider communication is a cornerstone of patient-centered care. Patient portals provide an effective method for secure communication between patients or their proxies and their health care providers. With greater acceptability of patient portals in private practices, patients have a unique opportunity to manage their health care needs. However, studies have shown that less than 50% of patients reported accessing the electronic health record (EHR) in a 12-month period. We used HINTS 5 cycle 1 and cycle 2 to assess disparities among US residents 18 and older with any chronic condition regarding the use of EHR for secure direct messaging with providers, to request refills, to make clinical decisions, or to share medical records with another provider. The results indicate that respondents with multimorbidity are more likely to share their medical records with other providers. However, respondents who are 75 and older are less likely to share their medical records with another provider. Additionally, respondents who are 65 and older are less likely to use the EHR for secure direct messaging with their provider. Additional health care strategies and provider communication should be developed to encourage older patients with chronic conditions to leverage the use of patient portals for effective disease management.
Collapse
|
16
|
Dekker AB, Bandell DL, Kortlever JT, Schipper IB, Ring D. Factors Associated with Patient Willingness to Conduct a Remote Video Musculoskeletal Consultation. THE ARCHIVES OF BONE AND JOINT SURGERY 2020; 8:656-660. [PMID: 33313344 PMCID: PMC7718570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Remote video consultations on musculoskeletal illness are relatively convenient and accessible, and use fewer resources. However, there are concerns about technological and privacy issues, the possibility of missing something important, and equal access to all patients. We measured patient characteristics associated with willingness to conduct a remote video musculoskeletal upper extremity consultation. METHODS One hundred and five patients seeking specialty musculoskeletal care completed questionnaires addressing (1) demographics, (2) access to a device, internet, and space to conduct a remote video consultation, (3) health literacy, (4) pain intensity, (5) magnitude of limitations of the upper extremity, (6) self-efficacy, and (7) rated willingness to conduct a remote video musculoskeletal consultation (11-point ordinal scale). A multivariable linear regression analysis sought factors independently associated with patient willingness to conduct remote video musculoskeletal upper extremity consultations. RESULTS Patient education level (4 years of college) and accessibility to a space suitable for remote video consultations were independently associated with interest in remote video consultations. Sociodemographic factors, health literacy, accessibility to a device or internet, and amount of perceived pain and disability were not. CONCLUSION We speculate that education level and suitable space might be surrogates for trust and privacy concerns. Future research might measure the ability of interventions to gain trust and ensure privacy to increase willingness to engage in remote video musculoskeletal consultations.
Collapse
Affiliation(s)
- Anne-Britt Dekker
- Dell Medical School Austin, The University of Texas at Austin, TX, USA
| | | | | | | | - David Ring
- Dell Medical School Austin, The University of Texas at Austin, TX, USA
| |
Collapse
|
17
|
Kindratt TB, Atem F, Dallo FJ, Allicock M, Balasubramanian BA. The Influence of Patient-Provider Communication on Cancer Screening. J Patient Exp 2020; 7:1648-1657. [PMID: 33457626 PMCID: PMC7786660 DOI: 10.1177/2374373520924993] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Few studies have examined how different qualities and modes (face-to-face vs electronic) of patient–provider communication (PPC) influence cancer screening uptake. Our objective was to determine whether receiving a breast, cervical, and colorectal cancer screening is influenced by (1) qualities of face-to-face and (2) the use of e-mail PPC. We analyzed Health Information National Trends Survey 4, cycles 1 to 4 data. To assess qualities of face-to-face PPC, adults reported how often physicians spent enough time with them, explained so they understood, gave them a chance to ask questions, addressed feelings and emotions, involved them in decisions, confirmed understanding, and helped them with uncertainty. Adults reported whether they used e-mail PPC. We used multivariable logistic regression to evaluate the odds of receiving cancer screenings based on face-to-face and e-mail PPC. Adults whose health-care providers involved them in decision-making had highest odds of receiving breast (odds ratio [OR] = 1.38; 95% confidence interval [CI] = 1.11-1.71), cervical (OR = 1.30; 95% CI = 1.06-1.60), and colorectal (OR = 1.25; 95% CI = 1.03-1.51) cancer screenings. No significant associations were observed between e-mail PPC and cancer screenings. More research is needed to explore this association.
Collapse
Affiliation(s)
- Tiffany B Kindratt
- Public Health Program, Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA
| | - Folefac Atem
- Department of Biostatistics and Data Science, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Florence J Dallo
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, Rochester, MI, USA
| | - Marlyn Allicock
- Department of Health Promotion and Behavioral Sciences, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Center for Health Promotion and Prevention Research, UT Southwestern-Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA
| | - Bijal A Balasubramanian
- Center for Health Promotion and Prevention Research, UT Southwestern-Harold C. Simmons Comprehensive Cancer Center, Dallas, TX, USA.,Department of Epidemiology, Human Genetics, and Environmental Sciences, UT Health, School of Public Health Dallas, The University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
18
|
Abstract
PurposeThe purpose of this paper is to identify key countries and their focal research fields on the information divide.Design/methodology/approachLiterature was retrieved to identify key countries and their primary focus. The literature research method was adopted to identify aspects of the primary focus in each key country.FindingsThe key countries with literature on the information divide are the USA, China, the UK and India. The problem of health is prominent in the USA, and solutions include providing information, distinguishing users’ profiles and improving eHealth literacy. Economic and political factors led to the urban–rural information divide in China, and policy is the most powerful solution. Under the influence of humanism, research on the information divide in the UK focuses on all age groups, and solutions differ according to age. Deep-rooted patriarchal concepts and traditional marriage customs make the gender information divide prominent in India, and increasing women’s information consciousness is a feasible way to reduce this divide.Originality/valueThis paper is an extensive review study on the information divide, which clarifies the key countries and their focal fields in research on this topic. More important, the paper innovatively analyzes and summarizes existing literature from a country perspective.
Collapse
|
19
|
Seale DE, LeRouge CM, Ohs JE, Tao D, Lach HW, Jupka K, Wray R. Exploring Early Adopter Baby Boomers' Approach to Managing Their Health and Healthcare. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2019. [DOI: 10.4018/ijehmc.2019010106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The Patient 3.0 Profile is used to explore to the patient engagement strategies of early adopter baby boomers' in three domains: 1) patient relationships, 2) health information use and 3) consumer health technology (CHT) use. Findings from six focus groups with early adopter boomers challenge prior notions about older adults' passive approach to patient engagement. Baby boomers want to make final healthcare decisions with input from providers. While adept at finding and critically assessing online health information for self-education and self-management, boomers want providers to curate relevant and trustworthy information. Boomers embrace CHTs offered through providers (i.e., patient portals, email and text messaging) and sponsored by wellness programs (i.e., diet and activity devices and apps). However, there is no indication they add information to their online medical records or use CHT for diagnosis, treatment or disease management. Additional resources are needed to encourage widespread adoption, support patient effectiveness, and confirm cost-benefit.
Collapse
Affiliation(s)
| | | | | | | | - Helen W. Lach
- Saint Louis University, School of Nursing, Saint Louis, USA
| | - Keri Jupka
- National Center for Parents as Teachers, Saint Louis, USA
| | | |
Collapse
|
20
|
Asan O, Crotty B, Nagavally S, Egede LE. Patient Centered Communication and E-Health Information Exchange Patterns: Findings From a National Cross-Sectional Survey. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 7:2200107. [PMID: 30588412 PMCID: PMC6302924 DOI: 10.1109/jtehm.2018.2884925] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/10/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022]
Abstract
This paper aimed to determine whether there was a connection between patient’s perception of communication with their doctors in the visit and their use of online health information exchange using a nationally representative survey. We used the data from the Health Information National Trends survey pooled HINTS4 Cycle 4 data and assessed outcomes using logistic regression modeling composite communication scores as a continuous variable. We weighted participants to create population-level estimates. We adjusted for age, gender, race, and census region. The 3677 patients were included in the analysis who had an outpatient visit within the previous 12 months. In unadjusted analysis and analysis adjusted for demographic factors, patients who experienced higher communication scores were more likely to use online health information exchange with their providers. In unadjusted analysis, patients had 0.04 higher odds of interest in receiving appointment reminders from health care providers electronically (OR = 1.04 and \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p=0.01$
\end{document}) and 0.03 higher odds of interest in receiving general health tips (OR = 1.03 and \documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p=0.04$
\end{document}) for every score increase in the communication summary score. In adjusted model, for each score increment in the communication score, patients were 7% more inclined to receive appointment reminders (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p< 0.05$
\end{document}), 4% more inclined to receive general health tips (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p=0.02$
\end{document}), and 4% more likely to exchange information about lifestyle behaviors (\documentclass[12pt]{minimal}
\usepackage{amsmath}
\usepackage{wasysym}
\usepackage{amsfonts}
\usepackage{amssymb}
\usepackage{amsbsy}
\usepackage{upgreek}
\usepackage{mathrsfs}
\setlength{\oddsidemargin}{-69pt}
\begin{document}
}{}$p=0.02$
\end{document}). Findings suggest that the quality of the communication in the visit might increase use of informatics tool to exchange health information.
Collapse
Affiliation(s)
- Onur Asan
- School of Systems and EnterprisesStevens Institute of TechnologyHobokenNJ07030USA
| | - Bradley Crotty
- Collaborative for Healthcare Delivery Science, Center for Advancing Population ScienceMedical College of WisconsinMilwaukeeWI53226USA
| | - Sneha Nagavally
- Center for Advancing Population ScienceMedical College of WisconsinMilwaukeeWI53226USA
| | - Leonard E Egede
- Center for Advancing Population ScienceMedical College of WisconsinMilwaukeeWI53226USA
| |
Collapse
|
21
|
Wang Y, Do DP, Wilson FA. Immigrants' Use of eHealth Services in the United States, National Health Interview Survey, 2011-2015. Public Health Rep 2018; 133:677-684. [PMID: 30223716 DOI: 10.1177/0033354918795888] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES Little is known about the use of electronic health (eHealth) services supported by information technology in the United States among immigrants, a group that faces barriers in accessing care and, consequently, disparities in health outcomes. We examined differences in the use of eHealth services in the United States by immigration status in a nationally representative sample. METHODS We used data from the 2011-2015 National Health Interview Survey to assess use of eHealth services among US natives, naturalized citizens, and noncitizens. Our outcome variable of interest was respondent-reported use of eHealth services, defined as making medical appointments online, refilling prescriptions online, or communicating with health care professionals through email, during the past 12 months. We analyzed use of eHealth services, demographic characteristics, socioeconomic status, and health status among all 3 groups. We used multivariate logistic regression models to examine the association between immigration status and the likelihood of using eHealth services, adjusting for individual demographic, socioeconomic, and health characteristics. RESULTS Among 126 893 US natives, 18 763 (16.1%) reported using any eHealth services in the past 12 months, compared with 1738 of 15 102 (13.0%) naturalized citizens and 1020 of 14 340 (7.8%) noncitizens. Adjusting for socioeconomic factors reduced initial gaps: naturalized citizens (adjusted odds ratio [aOR] = 0.81; 95% confidence interval [CI], 0.75-0.87) and noncitizens (aOR = 0.81; 95% CI, 0.72-0.90) had approximately 20% lower odds of using eHealth services than did US natives. However, the differences varied by type of eHealth service. Immigrants with higher English-language proficiency were more likely to use eHealth services than were immigrants with lower English-language proficiency. CONCLUSIONS Targeted interventions that reduce socioeconomic barriers in accessing technology and promote multilingual electronic portals could help mitigate disparities in use of eHealth services.
Collapse
Affiliation(s)
- Yang Wang
- 1 Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - D Phuong Do
- 1 Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Fernando A Wilson
- 2 Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| |
Collapse
|
22
|
Mathijssen EGE, Vriezekolk JE, Eijsbouts AMM, van den Hoogen FHJ, van den Bemt BJF. Support needs for medication use and the suitability of eHealth technologies to address these needs: a focus group study of older patients with rheumatoid arthritis. Patient Prefer Adherence 2018; 12:349-358. [PMID: 29563778 PMCID: PMC5846299 DOI: 10.2147/ppa.s152759] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The objectives of this study were to explore the needs of patients with rheumatoid arthritis (RA) regarding support for medication use and to gain insight into their perspective on the suitability of eHealth technologies to address these needs. METHODS Three focus groups were conducted with 28 patients with RA. Audio recordings made during the focus groups were transcribed verbatim. Two researchers independently performed an inductive, thematic analysis on the data (ie, the transcripts and field notes). RESULTS The following three themes that described support needs of patients with RA for medication use were identified in the data: 1) informational support; 2) practical support; and 3) emotional support. Informational support reflected the provision of information and facts, including advice, suggestions, and feedback from health care providers. Practical support included the reinforcement of practical skills as well as the provision of medication aids and pharmacy services. Emotional support reflected a trusted patient-health care provider relationship, characterized by good communication. Although potential advantages of eHealth technologies to address the patients' support needs were recognized, concerns over matters such as personal interaction with health care providers, privacy and data security, and the quality and reliability of online information were prevalent. CONCLUSION Patients with RA have informational, practical, and emotional support needs for medication use. Informational support seems to be most important. From the patients' perspective, eHealth technologies may have the potential to address these needs. However, these technologies are regarded as a complement to, rather than a replacement of, current practices.
Collapse
Affiliation(s)
- Elke GE Mathijssen
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Correspondence: Elke GE Mathijssen, Department of Rheumatology, Sint Maartenskliniek, PO Box 9011, 6500 GM, Nijmegen, the Netherlands, Tel +31 24 365 9185, Fax +31 24 365 9154, Email
| | | | - Agnes MM Eijsbouts
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
| | - Frank HJ van den Hoogen
- Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands
- Department of Rheumatology, Radboud University Medical Centre, Nijmegen, the Netherlands
| | | |
Collapse
|
23
|
Rooks RN, Kapral CG, Mathis AL. Chronic Conditions May Be More Important Than Race or Ethnicity in Relation to Health Information Seeking and Use. J Aging Health 2017; 31:611-630. [PMID: 29254425 DOI: 10.1177/0898264317744643] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This research examines health information (HI) seeking and use among middle-aged and older adults with chronic health conditions. METHOD We used logistic regression models to analyze HI seeking ( N = 7,822) and use (N = 4,541-4,547) among participants (aged 45+ years) with chronic conditions from the nationally-representative Health Tracking Household Survey. RESULTS Adults aged 45+ years with chronic conditions were significantly more likely to seek and use HI; however, these results varied based on the age and education. Compared with Whites, Latinos were less likely to seek HI but more likely to use HI to treat illness, and African Americans were more likely to use HI to maintain health. CONCLUSION Middle-aged and older adults with chronic conditions are prominent HI seekers and users. Proficient HI seeking and use may have the potential to enhance control over one's own health, maintain independence in the community, and reduce the impact of negative health consequences on the health care system.
Collapse
|